Hand-foot-and-mouth disease historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]

Overview

Notable outbreaks have occurred in Malaysia, Taiwan and China in the past. Hand, foot and mouth disease infected 1 520 274 people with 431 deaths reported up to end of July in 2012 in China. .

Historical Perspective

Recorded outbreaks

• In 1997, 34 children died in an outbreak in Sarawak, Malaysia.
• In 1998, there was an outbreak in Taiwan, affecting mainly children. There were 405 severe complications, and 78 children died. The total number of cases in that epidemic was estimated to be 1.5 million.
• In 2006, 7 people died in what seemed to be a new outbreak in Kuching Sarawak (according to the New Straits Times, 14th of March).
• In 2006, after the outbreak of Chikungunya in Southern and some Western parts of India cases of HFMD were reported.
• In 2007, during the week of April 15-21 alone, Singapore recorded 688 cases of the disease.
• In 2007, 30th May, outbreak in the Maldives was reported.
• In 2008, an outbreak in China, beginning in March in Fuyang, Anhui, led to 25,000 infections, and 42 deaths. Similar outbreaks were reported in Singapore (more than 2,600 cases as of April 20, 2008), Vietnam (2,300 cases, 11 deaths), Mongolia (1,600 cases), and Brunei (1053 cases from June–August 2008)
• In 2009, 17 children died in an outbreak during March and April 2009 in China's eastern Shandong Province, and 18 children died in the neighboring Henan Province. Out of 115,000 reported cases in China from January to April, 773 were severe and 50 were fatal.
• In 2010, in China, an outbreak occurred in southern China's Guangxi autonomous region as well as Guangdong, Henan, Hebei and Shandong provinces. Until March 70,756 children were infected and 40 died from the disease. By June, the peak season for the disease, 537 had died.
• In 2010 in Vietnam, by 04.09 the disease was reported to have claimed 98 lives, 75% of whom were children under 3 years old. Although there was no official declaration of an outbreak, over 42,000 cases were reported. Over 10,000 new cases were recorded in the second half of August alone.
• The World Health Organization between January to October 2011, (1,340,259) states the number of cases in China dropped by approx 300,000 from 2010 (1,654, 866) cases, with new cases peaking in June. 437 deaths, down from 537 deaths in 2010.
• In Cambodia, 52 of 59 reviewed cases of children reportedly dead (as of 09 July 2012) due to a mysterious disease was diagnosed to be caused by a virulent form of HFMD. Although a significant degree of uncertainty exists with reference to the diagnosis, WHO report states, "Based on the latest laboratory results, a significant proportion of the samples tested positive for enterovirus 71 (EV-71), which causes hand foot and mouth disease (HFMD). The EV-71 virus has been known to generally cause severe complications amongst some patients."

United States

• In 2012 in Alabama, United States there was an outbreak of an unusual type of the disease. It occurred in a season it is not usually seen and affected teenagers and older adults. There were some hospitalizations due to the disease but no reported deaths.